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AMERICAN VALLEY 162175 <br /> VIIAST� {SIL, INC. <br /> Invoice Number: <br /> P.O. Bax 340• Delhi, CA 95315 <br /> PH. 1-800-7 2-4645 • FAX 209-668-3880 <br /> A#`CAR000272302 <br /> BILL TO: GOLDEN STATE AUTO REP IR _( . <br /> 1587 FRENCH CAMP RD TOB SITE: GOLDEN STATE AUTO REPAIR <br /> STOCKTON, CA 95206 1587 FRENCH CAMP RD Invoice Date: <br /> X TURNPIKE <br /> STOCKTON,CA 952()6 <br /> Phon19,,,-3.53 Custom r P` SsIeS� <br /> Terms COD EPA# <br /> PRODUCT SHIPPING DESCRIPTION CAL000383667 <br /> WASTE MANIFEST UANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used Oil/Mixed Oils 221 <br /> NON-RCRA Waste Liquid Used Antifreeze133 <br /> ------_ <br /> NON-RCRA Waste Liquid Used Oily Water 223 <br /> Drained Used Oil Filters <br /> OIL COLLECTION FEE <br /> Yl� q5.W <br /> Safes Tax <br /> TERMS: Invoices over Days are subject to a 1.5%service charge. Customer agrees to pay all legal tees if court action <br /> becomes necessary to collect this invoice. TOTAL <br /> By signing i herby certify that I have not mixed any of the waste described above with any other hazardous waste,the total halide content Is LESS than 1,000 t <br /> waste does not contain any PCBs.!have complied with the <br /> accept the additional charges for the disposal of this Waste if therm cents of on the <br /> applicable California used oil management PI agree <br /> and the <br /> tag regulation to determine this is true.I agree io <br /> Generator's Certification:By signing i certify that it I am a large uanti[ Provided about this waste is incorrect. <br /> cert <br /> have a <br /> ed to the degree i have determined to be economically affordable and that I have selected the tPracticable romethod ram inofltreatment stace to otrage oir disposal currently available to al- <br /> which minimizes the present and future threat to human life and the environment:Or,if i am a small quantity generator t have made a Good filth effort currently <br /> minintly izemy wasme <br /> te <br /> generation and select the waste management method that is available to me that i can afford. <br /> American VaNey Waste Oil hereby advises the above Generator that generators shipment of used oil maybe transported to a facility that is required to comply with federal <br /> regulations applicable to management of used oil,but that Is not required to comply with the more stringent requirements <br /> 1 ties.California facilities that handle or process used oil are required to meet those more stringent requirement,and some out-of-state aitetfacilttles that process used oil also meet <br /> those requirements,engineering certiffcatfons of tank integrity,and financial assurances for closure and accidental releases,It is lawful to send used oil to out of state facilities <br /> that comply only with federal used oil management standards and not these more stringent requirements. <br /> This notification is for information purposes only. <br /> By both parties signing this invoice it will servo as an agreement that American Valley Waste Oil will submit confirmation for(certain waste streams)to the generator that their <br /> waste has been transported to a licensed treatment oi-transfer facility. <br /> DRIVER GENERATOR <br /> SIGNATURE t AUTHORI <br /> DATE(l 111 "' SIGNAT RE: <br /> DATE Id <br /> DISPOSAL/ RE-CYCLING FACILITY <br /> O DK-DIXON O ASBURY ENVIRONMENTAL RIVERBANK OIL TRANSFER Q CFR <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 5300 CLAUS RD. O GLOBAL MATERIAL MGMT <br /> DIXON,CA 95620 CERES,CA 95358 2035 E.15TH ST. 1640 N.BROADWAY <br /> 707-693-6008 RIVERBANK, CA 95367 LA,CA 90021 STOCKTON,CA 95205 <br /> 209.541-1825 209-863-8181 213-746-0237 <br /> EPA#CAT080012602 EPA#CAL0003193680 EPA#CAL000190816 EPA#CAL000270577 EPA#818-770-25770417316 <br /> 0-CAL0000 <br /> EPA# 04i 7316 <br /> --- MPC(72016) <br />